Jim Ramstad was first elected to Congress in 1990. He is a member of the House Ways and Means Committee and serves on its Trade and Oversight subcommittees. Ramstad is also founder of the bipartisan House Medical Technology Caucus, as well as co-chair of the House Law Enforcement Caucus.

He is former Criminal Justice Act attorney and adjunct professor of government and constitutional law. Before his election to Congress, he served three terms in the Minnesota Senate where he was Assistant Minority Leader. As a young state senator in 1981, Ramstad was arrested for disorderly conduct, resisting arrest and failure to leave a South Dakota coffee shop at 2 a.m.. After waking up from an alcoholic blackout in a jail cell, Ramstad made a commitment to go to treatment and he checked himself into St. Mary’s Rehabilitation Center, now Fairview Recovery Services in Minneapolis, Minnesota. Of this experience, he said, “The more honest I became with people about my alcoholism, the more they were supportive and embraced me.”

In turn, people confided in him about their own problems of addiction, and those of family members. Ramstad hopes to steer alcoholics and addicts toward recovery with the passing of the Substance Abuse Treatment Parity Act, legislation that he introduced to the House of Representatives on September 4, 1997. The Substance Abuse Treatment Parity Act is a bill to give alcoholics and drug addicts more access to treatment by prohibiting health insurers from placing discriminatory caps, financial requirements, or other restrictions on treatments that are different from other medical and surgical services. The passage of this bill would put chemical dependency on par with insurance coverage for other diseases.

PC: You’ve said that you realize the value of treatment because you have first hand experience as a recovering alcoholic. Did you receive treatment for alcoholism, and if so, can you tell me about your experience regarding insurance provisions you may or may not have had at that time?
JR: Yes, I have seen first hand the value of treatment because I went through treatment back in 1981. I was one of the fortunate chemically dependent patients because my insurance policy covered my entire 28-day treatment. As a grateful recovering alcoholic, I’ve seen the value of treatment for people like me who are chemically dependent. As someone who stays close to professionals and recovering people everyday, I’ve talked to several thousands of chemically dependent people who have been discriminated against, by being denied access to treatment.

PC: How has that affected their lives?
JR: It’s been devastating. Many of these people continued using; continued drinking. Their lives have been shattered, their marriages, careers, families ruined. Their kids are on Prozac. The consequences are tragic, and that’s why I have such a passion for the Substance Abuse Parity legislation. Clearly addiction is America’s number one public health and public safety problem and it’s time we deal with it.

PC: What are the key reasons that you feel that the passage of this bill is necessary?
JR: Alcoholism and drug addiction are painful private struggles with staggering public costs. I mention in my litany of costs, the human cost, but the dollar costs are staggering as well. The direct and indirect costs of alcoholism alone in this country exceeded $90 billion last year. If combined, the indirect and direct costs of addiction in America, equal over $200 billion annually. So, insuring access to treatment, as we are trying to do in this legislation, will not only combat this insidious disease, but will save literally billions of healthcare dollars in the long run.

PC: How much higher are heathcare costs for untreated alcoholics and addicts?
JR: It’s well-documented that untreated alcoholics and drug addicts, on the average, incur health costs 100 percent higher than non addicted people. People need to know that for every dollar we invest in health care it saves $7 in healthcare costs, social welfare costs, incarceration costs, and other related costs of addiction. So, the best investment we can make is to provide treatment to people who are chemically dependent.

PC: What would be the major benefits to addicts and the country at large if this bill were passed?
JR: The legislation that [Democratic ] Senator [Paul] Wellstone and I are pushing doesn’t increase tax dollars one penny. The worst case scenario is that it will increase health insurance premiums by one-half of 1 percent. Which means for the price of a cup of coffee per month — a $1.35 increase in your healthcare insurance premiums per month — we can treat 16 million Americans. It’s the best investment we could ever make as a nation. In fact, one of the two doctors who treated former first lady, Betty Ford, testified that this legislation would help more people directly than anything Congress has done since passing the Social Security Act in 1934.

PC: I understand that one reason that this bill is so hard to get passed is that opponents of parity argue that it would be too expensive. You have backed it with studies and other evidence that supports just the opposite — that parity would save healthcare dollars in the long run because people would stay healthier longer and save the healthcare system money on substance-related illnesses. So, why is it so hard to pass this bill?
JR: We have some strong forces lobbying against us, namely the insurance industry. They just don’t get it. They don’t understand that it’s in their best interest to treat more people, to be preventive and to deal with this disease instead of paying the cost that results from addiction. Right now, they are paying out millions and millions of dollars in costs related to addiction. If they would just understand the nature of the disease and that treatment works and is cost- effective they wouldn’t oppose it.

PC: Do some insurance companies understand the disease concept of addiction?
JR: Not all insurance companies are unenlightened, but unfortunately too many of them still need to be educated on the nature of the disease and the value of treatment. Untreated alcoholics incur healthcare costs 100 percent higher than people who have been treated do. Their livers go. They get in car accidents when they are drunk — all the horror stories that happen because of addiction. Many of those dollars can be saved if we treat those people who are still suffering the ravages of addiction.

PC: How can insurance companies be sure that the parity will be cost-effective?
JR: We have a built-in exemption here for small businesses with less than 100 employees. The parity doesn’t apply to them, and the requirement of the parity would be waived if premiums went up 1 percent or more, so there’s built in guarantees that this legislation is going to be cost-effective.

PC: I understand that you have support from former President Gerald Ford and his wife, Betty; General Barry McCaffrey, director of the Office of National Drug Control Policy; 17,000 treatment professionals of the National Association of Alcohol and Drug Abuse Counselors [NAADA]; and physicians of the American Society of Addiction Medicine. How many supporters of the bill have come forth?
JR: I’ve got the support of drug czar, McCaffrey. He is one who understands. I hope we can get the President’s problems behind us, and the White House can become engaged, because they haven’t been engaged. They have been preoccupied with the Monica Lewinsky mess, and quite frankly, many of the members of Congress have been consumed in the scandal, so that’s part of the problem. We haven’t been able to concentrate on the legislative process like we should, and as a result, some very good pieces of legislation like this one have fallen victim. We have to pick up where we left off. We have a lot of momentum on our side; we have 96 co-sponsors in the House and they include members of both parties, both ideological extremes, and most of them are returning to the new Congress. Hopefully we will pick up some new supporters among the new members who are selected to the House.
We have a real strong bipartisan
coalition representing the entire
ideological spectrum in the House of Representatives.

PC: At one point you wanted to add this as an amendment to the Drug Demand Reduction package. Why did you withdraw that amendment?
JR: We didn’t withdraw it. We got rolled by the Rules Committee. They wouldn’t let us offer it. The Rules Committee controls the process. They claimed that my bill wasn’t germane, and then I changed it to make it germane and then they found another argument. So, the fix was on and our leadership blocked my legislation.

PC: Are there other health-related bills to which you are considering adding the parity act?
JR: I’d like to see it passed on its own merits as a free-standing vehicle, but that doesn’t happen very often in the process. Usually legislation, especially controversial legislation like this, passes as an amendment to something else. That’s just the way the process works. Mental Health Parity, didn’t pass as a free-standing vehicle, because usually there is a bigger bill, a more ominous bill that it’s attached to. I am looking for any vehicle, any way to pass this bill that’s legal and ethical. This is a life and death issue. This is not just another public policy issue and so I’m looking for any means to get this legislation passed. We are going to make an all-out effort to get it passed.

PC: Why is it that in 1998 only 2 percent of the sixteen million Americans covered by health insurance plans which purport to cover chemical dependency treatment are able to get effective treatment for substance abuse? How does coverage for that 2 percent differ from others?
JR: Because insurance companies have erected barriers to treatment that they don’t erect for other diseases covered by health plans: Artificially high co-payments, artificially high deductibles, and they limit treatment stays to an average of two to seven days. Well, nobody can get effective treatment for chemical dependency in two to seven days. I mean, it’s ludicrous.

PC: How have those caps placed on treatment coverage by insurance companies affected alcohol and substance abuse treatment facilities?
JR: In the last decade over half the treatment centers in America, half the treatment beds have disappeared. Over 60 percent of the adolescent beds have gone over the last decade because insurance companies are not paying for treatment, although they purport to. Bottom line in a nutshell is that’s what this legislation does. It says it’s time to put chemical dependency on par with health insurance coverage for other diseases. It knocks down the barriers to treatment that have been erected by insurance companies. It assures access to treatment for alcoholics and drug addicts just like people have access to treatment for diabetes or heart disease, or liver disease or migraine headaches or whatever disease it might be. All it says is “look, treat alcoholics and addicts like you treat other diseases.” The premise of this legislation, if you accept the fact that alcoholism and drug addiction are diseases like the American Medical Association has told us since 1956, then you have to accept parity, you can’t rationalize discrimination against the disease of addiction.

PC: How do you rank the effect of alcoholism and addiction on the American people?
JR: The effect [of alcoholism and addiction] on the American people is getting worse, and like I said to my colleagues, we can deal with the disease now, or we can deal with it later and it’s going to be much more expensive in terms of human lives, in terms of dollars, the longer we wait. And so, the problem isn’t getting any better. We can build all the barriers around the country, and hire all the border controls and do all the interdiction efforts under the sun but if we don’t deal with the demand side, if we don’t provide treatment, we’re never going to get at the problem. We are never going to effectively deal with the problem of addiction in America. For so long the government has concentrated almost exclusively on the supply side and ignored the demand side. It’s time to shift our priorities because quite frankly all the evidence showed that strategy to ignore prevention and treatment has been a colossal failure.

PC: Minnesota saves $22 million in annual healthcare costs because of treatment. Is Minnesota a forerunner in providing insurance coverage for treatment?
JR: Yes, Minnesota has been very progressive. It’s been a leader in the effort to provide treatment to chemically dependent people. It’s worked in Minnesota and it can work in the rest of the nation.

PC: What is the next step toward getting this bill passed?
JR: The next step is to reintroduce it when we go back January 6. I have to get co-sponsors starting from scratch. The support is mounting for this legislation, and I’m confident we are going to get it passed this year. It’s not only the cost-effective thing to do but it’s the right thing to do. We just have to educate some key members of Congress who don’t understand the nature of the disease or the value of treatment. We have educated a number of people. Professional treatment counselors of the National Association of Drug Abuse Counselors (NADAC) were very helpful last year, as were recovering people. We need a big push this year to get this legislation passed. I’d like to get the American people behind the bill — hopefully recovering people from around the country who understand the value of treatment first hand, and who will rally around this bill and put pressure on their members of Congress so that the goal of Substance Abuse Treatment Parity will become a reality.

Rep. Jim Ramstad, R-Minn,. is a member of the Ways and Means Committee and chief House sponsor of H.R. 2409, the Substance Abuse Treatment Parity Act.
To show support for this legislation, compose a letter to your Senator and/or Congressman in the following manner.

Date

The Honorable (insert full name)
U.S. House of Representatives (or U.S. Senate)
Washington, DC 20515

Dear Representative (or Senator) (insert last name)

I am writing to you in support of the Substance Abuse Treatment Parity Act, introduced by Rep. Jim Ramstad (or in the Senate, Senator Wellstone). This bill would give alcoholics and drug addicts access to treatment by prohibiting health insurers from placing discriminatory caps, financial requirements or other restrictions on treatment that are different from other medical and surgical services.

As a provider of treatment of the disease of addiction to alcohol and drugs, I know firsthand the value and effectiveness of treatment. Sadly, however, many individuals who need and want this life-changing treatment cannot access it, even when they thought their health insurance plan covered substance abuse treatment.

This is because the current system either blocks access for people who are chemically dependent or greatly limits their treatment experience. It’s time to put chemical dependency on par with insurance coverage for other diseases. In addition, assuring access to treatment will not only combat the disease; it will also save health-care dollars.
I respectfully request that you cosponsor and strongly support this legislation.

Sincerely,

(Print clearly your name, address and phone.)

Comments

Add New Search RSS

Write comment
Name:
Email:	do not notifynotify
Title:
	Please input the anti-spam code that you can read in the image.

Powered by !JoomlaComment 3.26

3.26 Copyright (C) 2008 Compojoom.com / Copyright (C) 2007 Alain Georgette / Copyright (C) 2006 Frantisek Hliva. All rights reserved."

---